Firstly is rotator cuff injuries (strains or tears) – these are caused by overuse or acute injury. The tendons that connect muscles to bones can overstretch (strain) or tear, partially or completely. The rotator cuff can also strain or tear after a fall, an accident, or another sudden injury. These injuries typically cause intense and immediate pain.

Secondly is Tendinitis – this is an injury usually caused by overuse of the rotator cuff. Common amongst those that play a lot of racket sports or any form of lifting activity that requires us to stretch our shoulders above head height. This type of repetitive movement can cause the joints to become inflamed.

Lastly is Bursitis – this is another common rotator cuff injury caused by inflammation of the bursa. These are fluid-filled sacs that sit between the rotator cuff tendons and the underlying bone.

Not all rotator cuff injuries cause pain, however. Some are the result of degenerative conditions, which means that the rotator cuff could be damaged or injured for months, even years, before symptoms start to appear!

How to know when we may be suffering with a rotator cuff injury

• difficulty achieving full range of shoulder motion
• difficulty sleeping on the affected shoulder
• pain or tenderness when reaching overhead
• pain in the shoulder, especially at night
• progressive weakness of the shoulder
• trouble reaching behind the back
• How can we treat rotator cuff injuries?

Treatments range from resting, to Physiotherapy, to surgery depending on the severity. Tendinitis can progress to a rotator cuff tear, and that injury can get worse with time. Seeking treatment as quickly as possible helps keep the injury from progressing. If you try resting your injury and it doesn’t make significant improvements after a week then it is advised you seek professional advice from your Physiotherapist.

Non-surgical treatments are found to improve symptoms in around 50% of people with a rotator cuff injury, such as:

• applying ice and heat to the affected shoulder to reduce swelling
• light exercises and stretching to restore strength and range of motion
• injecting the affected area with cortisone, a steroid that helps to reduce inflammation
• resting the affected arm and using support to isolate the injury
• over-the-counter anti-inflammatory medications, such as ibuprofen

Find out more about our Physiotherapy services?

On top of this, our feet are often subject to common conditions such as verruca’s, in-growing toenails and dry skin, not to mention the side effects from less common conditions such as diabetes, cancer, rheumatoid arthritis, osteoarthritis and circulatory problems – so, it’s no wonder we need to take more care of our feet and embrace the importance of foot health!

What can our Podiatrists do?

Our Podiatrists will be able to help reduce the pain and discomfort as we manage the corn and callous build-ups. Through our comprehensive foot assessments, we are able to determine the root cause of the corn and/or callus and talk you through ways to ensure repeat problems can be kept to a minimum. We believe regular maintenance appointments are important in order to ensure future issues with our feet are limited.

Incorrect and/or inappropriate footwear for our feet is a particular concern as it is often the last thing we think about when purchasing footwear. The correct footwear differs depending on a number of things ranging from weight, posture, foot alignment and any current or past injuries. Incorrect footwear can also increase our risk of running injuries, including lower back, leg, knee, ankle and foot pain. Our Podiatrists can effectively advise on the best and most appropriate footwear, as well as provide biomechanical assessments and/or prescribe orthotics (also known as orthotic insoles, shoe inserts, or orthoses) where appropriate to restore natural foot function.

How to book a Podiatry appointment in Burnley?

If you wish to book an appointment with one of our therapists, you can call us on 01282 453 110, or leave us a message using our FREE Ask an Expert service.

The cold provides pain relief as it decreases the action of nerves in the area of pain and reduces blood flow, slowing down cellular activity.

Heat should be used on muscle issues, chronic pain, and stress. The heat from either a wheat bag or hot towel helps to take the edge off symptoms such as muscle aching, stiffness and chronic pain. It is particularly useful for back pain, helping to relieve the build-up of tension in the upper back, neck and shoulder area that so often comes from an issue with our back.

Heat on an injured area can provide comfort and pain relief due to the effects it has on nerve stimulation, as well as, increasing blood flow and cellular activity, which are important in encouraging the healing of damaged tissue. Heating an area can also help it to become more flexible.

For further muscle relief an option that we recommend is a massage treatment to help relieve any sore muscles caused by over working or tight tissue.

The do’s and don’ts with ice and heat

Both ice and heat have the potential to do some minor, temporary harm when used incorrectly. Heat can make inflammation significantly worse and ice can aggravate symptoms of tightness and stiffness; it can also just make any pain worse when it’s unwanted.

Both ice and heat are pointless if used incorrectly or in the wrong situation.

We must be especially wary of icing muscle pain. It is quite easy to suffer with pain in our back that isn’t the cause of an “injury”. For example, muscle knots aren’t considered an injury – they are usually a symptom of an underlying issue. Physiotherapists use trigger point release to help muscle knots and if we don’t particularly know what we’re doing and we happen to ice trigger points, they can burn and ache even more acutely.

Heat and inflammation are the other particularly bad combination. Adding heat to a fresh injury will only make it worse. The heat will increase the swelling and unfortunately the pain!

The general rule is to ice and injury and to heat aches and pain, so you may be wondering, what do we do for muscle injuries (a muscle tear or muscle strain) then?

It’s not always that easy, but generally, ice usually wins — but only for the first few days at most, and only if it really is a true muscle injury. A true muscle injury usually involves obvious trauma during intense effort, causing severe pain suddenly. If the muscle is truly torn, then use ice to take the edge off the inflammation at first. Once the worst is over, switch to heat.

If you are still unsure what to do with a particular issue, feel free to get in touch with your local physiotherapist, we’re always more than happy to help with anything like this. Message our team of experts directly using our FREE online service.

Alternatively, if you feel like you need treatment, you can choose between our Burnley and Padiham clinics to start your therapy.

The aim of a warm-up is to get our body ready for a run by increasing our circulation and warming up the muscles. Static stretching usually involves isolating a particular muscle and holding a stretch for approximately 30 seconds. The idea is that we’ll help improve muscle length and flexibility, ultimately reducing our chance of getting injured; however, there is no evidence to suggest that this is the case. Evidence suggests that acute stretching immediately before exercise can have a negative effect on performance due to the physiological changes seen in the muscle and the decreased ability to store elastic energy (Wilson et al, 2010). Therefore, static stretching can in fact have an undesirable effect on performance particularly that of endurance runners.

The Myths – should we perform a warm-up prior to running?

It is suggested that the warm-up helps us to be mentally and physically ready for exercise, as well as warming up the muscles by increasing the circulation to the periphery. Since static stretches immediately prior to running may inhibit performance and possibly increase the risk of injury, it has been recommended to perform dynamic mobility exercises as an alternative. Dynamic mobility refers to controlled, repetitive sports-specific movements that mimic the way our muscles and connective tissues move during a run. Unlike static stretching there is no evidence to suggest that dynamic exercises immediately performed prior to running have a negative effect on performance; in fact, it might help us run faster! (Yamaguchi et al, 2015)

What dynamic mobility exercises should I include in my warm-up?

• Walking lunges
• Walking leg swings
• Bum kicks
• reps each side)
• Do long-hold static stretches have a place?

Although long-hold static stretching is not recommended immediately prior to running it still has its benefits. Long-hold static stretching performed regularly over a minimum of 6 weeks can significantly improve our flexibility. Therefore if we have a restriction in movement around a joint as a consequence of a running-related injury, it is important that we try to regain this reduction in muscle length through static stretching and eccentric strengthening. Getting an improvement in muscle length does take time though, so it is important to be consistent with our exercises.

If you need any advice on your preparations for exercise or a particular sport you play, feel free to use our FREE Ask A Physio service online, here. We would be happy to help you! Worst case, if you see or hear the word ‘myth‘ this is usually a good time to do your own research!

Sometimes, back pain is severe and causes referred pain – pain that goes into the buttocks or down the legs even into the feet or toes. When pressure is put onto the sciatic nerve this can cause severe pain, pins and needles and numbness down the legs. The cause of this pain can vary from a disc prolapse, tight muscles or joint impingement.

What can I do to help my back pain?

Fortunately, there are lots of ways of helping your back pain, whether it has just started or whether it is chronic and you have had it for years.

Get a clear diagnosis from a Physiotherapist!

Getting a clear diagnosis from a specialist is essential in being able to work out what treatment or exercises will help you specifically – a muscle strain, for example, is treated differently from a disc prolapse. Don’t take any chances with the health of your back. Quite often, it can be something of nothing, but in the cases that it isn’t, there’s no better place to go than a Physiotherapist.

Painkillers

If your back pain is severe there are some things you can do immediately, such as taking painkillers. Most people don’t want to take painkillers, but from a Physiotherapy point of view, they can be helpful. Firstly you will be in less pain – a good reason in itself! Secondly, if you are in less pain you may be able to move more freely which can help free up the muscles and joints around the back, speeding up recovery.

Heat

Using heat on your back can give some immediate relief: hot water bottles, wheat bags, a hot bath or shower, even going to the sauna. Heat works in two ways – it literally takes the pain away because the body thinks that heat (and cold) signals are more important than pain signals. Heat also helps relax back muscles which is a common cause of pain. TENS machines also work in a similar way – they are a little box which emits electrical signals to the skin that overrides pain signals and can encourage the body to reduce pain signals to the affected area. Often people benefit from heat in the short term, but it does not resolve symptoms, which often requires more active treatment.

Physiotherapy

Treatment options used by Physiotherapists include massage, joint mobilisation, home exercises, acupuncture, laser therapy and taping. We will use anything that will help you get better! Massage and acupuncture are useful in releasing tight muscles. Joint mobilisation helps to free up stiff joints and restricted nerves. Stretching exercises help to keep the muscles and joints freed up. Laser therapy is helpful in speeding up the healing process for muscle strains. Taping is also a useful technique to prevent movements that may cause pain or encourage muscles that are underused. We also plan your recovery so that you are aware of what is needed and when. You are able to measure your rehabilitation and focus on your recovery goals.

Posture

All back conditions benefit from working on your posture. Most of us know this but it is hard to maintain. A few tips: when using a computer try to sit upright as possible without straining your back. Try increasing the height of your monitor to eye level or getting a laptop raiser with a separate keyboard/mouse. If you are able to tilt your seat slightly forward this can help. How about sitting on a wobble cushion – this is an air-filled cushion that helps you tilt your hips forward and encourages you to sit up straight. You can start by using it for short periods e.g. 10 minutes at a time until your core strength builds up and you don’t need it any longer.

Keeping Moving

If you work at a desk or do a lot of driving you will also benefit from regular opportunities to move around even if for a few minutes. Some people find using a sit and standing desk helpful to alternate postures without the need to stop working. A simple exercise like walking can be useful to loosen your back up, sometimes it doesn’t need more rest.

Strengthening our core back muscles

For many people, poor posture has led to a weakening of postural muscle. These are smaller muscles which help us sit or stand up straight. Often, they get weak from excessive amounts of time sitting – at a desk or driving. It can be useful to be assessed by a Physiotherapist to check your core strength and learn some core strengthening exercises. Generally, these are Pilate’s exercises. If you want to develop core strength as well as flexibility one of our Pilates courses may be for you.

Relaxation

T-ai Chi and Yoga also work on core strength, flexibility and relaxation. Learning to relax can also help reduce our tension and back pain. Alexander technique classes are an excellent way of learning more about posture and reducing back tension through relaxation.

Should we sit less? Our bodies are fuelled by movement as this activates all of our internal chemical mechanisms that help us to function correctly. If we think about how we feel after a good work out, we tend to feel more relaxed and pain-free. This is because our body releases hormones known as ‘endorphins’ which interact and stimulate our brain.

Aches and pains from musculoskeletal injuries are often related to our static postures. For example, if we are sat working at our desks all day, our bodies will spend long periods of time hunched over causing some of our muscles to overwork and overcompensate for the muscles that aren’t being utilised correctly. This can make some of our muscles weaker and less effective when we need them – often resulting in an injury.

Being hunched over a desk can result in a ‘forward posture’, which is where our necks assume a leaning position that causes our centre of gravity to change. This influences the muscles we use and how we use them. For every inch of ‘forward head posture’, it can increase the weight of our heads by an additional 10 pounds! When you think that a stone is 14 pounds, that’s a significant amount of stress added to our muscles that are already overcompensating as it is.

Every time we use the wrong muscle groups for a specific action, we are risking an injury. We’re all aware of how we’re supposed to pick an item up off the floor – lift with our knees, not with our back. This is exactly so we don’t injure ourselves using muscles that aren’t designed for that purpose.

Sedentary lifestyles are one of the most common causes of injury because of the constant strains and demands we put on our bodies to hold us in an unnatural position.

To answer the question of should we sit less? Most certainly!

So, what can we do to help?

First and foremost, try to be more active. Even a quick 10-15 minute walk on your lunch breaks can significantly improve your well-being. Take several small breaks to stand up and stretch while you’re at your desk to help blood flow. If you can stand up while you work, even better! Start to think about including cardiovascular physical activity, strengthening and stretching exercises into your daily routine so that you can help reduce your chances of injury.

Having less of a sedentary lifestyle doesn’t take life-changing efforts, but it can have life-changing results

Unfortunately, low back pain is one of the most common pregnancy problems, however, this does not mean that we have to suffer throughout our pregnancies. Due to increased weight and a growing bump, our posture will change to accommodate the weight-related changes and alteration to our centre of gravity. As a result, more pressure and strain may be placed on the lumbar spine (the bottom of the back) to help maintain balance with our growing bumps.

There are certainly things we can do to help minimise and reduce the likelihood of developing low back pain. Minding our posture and using a lumbar roll when sat can help take some of the pressure and strain off of the lumbar spine. Completing gentle pelvic tilts can help alleviate pressure and stiffness in the area. Regular gentle aerobic exercises, such as swimming can help keep your back mobile and reduce tension on the muscles. When stood for periods of time, placing our foot up on a step can help reduce ache and pressure.

We can seek advice from a Physiotherapist who can review our posture and provide us with tailored exercises and stretches to reduce low back pain. They can also give advice on day to day activities, posture in work, review lifting techniques and provide hands-on treatment to reduce the aches and pains.

Symphysis pubis dysfunction

Symphysis pubis dysfunction (SPD) is characterised by pain in the centre of our groin, directly onto the pubic bone, radiating down the inner thigh. This is one of the most common pregnancy problems thanks to hormonal changes.

Quite early on during pregnancy, our bodies produce a hormone called relaxin – this hormone is responsible for the relaxation of ligaments and soft tissue throughout the body, preparing us for labour and delivery. Located centrally to the pelvis between the legs is a cartilaginous disc which connects the two sides of the pelvis. Typically, this joint is rigid and does not move unless we are pregnant due to relaxin.

SPD symptoms may include: a bruised bone sensation (even with light pressure), burning or altered sensation along the pubic bone, sharp pain radiating down the inner thigh or grinding/clicking noises from the pubic bone. Although we cannot stop the production of relaxin during pregnancy, there are things we can do to reduce and alleviate SPD.

As the pain is caused by the increased movement of the two halves of the pubic bone, it is important to keep our lower limbs moving symmetrically and with minimal torsion.

Getting in and out of bed – we should roll to our side, slide our legs off the bed as one and then sit ourselves up.
Walking – we should reduce our stride length and pace so our legs are not as far apart.
Climbing stairs – we should take it one step at a time or go up the side of the steps on, again, helping to reduce leg separation.
Sitting – we shouldn’t cross our legs as this can put increased pressure on the sore area.
Carrying – we must try to keep the weight of the object central to our body rather than carrying it on the hip, helping to maintain symmetry.
Resting – we can apply something cool to the centre of the groin to reduce ache – we just need to ensure that our skin and bump is protected with a towel.
A Physiotherapist will be able to review how we are moving and give advice on our posture and activities, as well as, reduce muscular tension around the pelvis and lower limbs through treatment.

Pelvic girdle pain (PGP)

Pelvic girdle pain usually involves all pains around the pelvis, this can be the front or back of the pelvis and can radiate up the back, into our bottom or down to our legs. Due to hormonal changes in pregnancy and the added weight and pressure of our bump, pains around the pelvis can be common. The joints within the pelvis may feel bruised, stiff or very mobile.

A Physiotherapist will be able to assess us and determine if we have PGP and which joints are affected. They can give us advice and education about how to move, postural advice when standing, sitting and lying down, and manual therapy to help alleviate the aches and pains, as well as exercises to keep things mobile and comfortable.

Carpal Tunnel and De Quervain’s Tenosynovitis

During pregnancy, our bodies take on a substantial amount of fluid retaining water due to hormonal changes. Because of this, swelling of the hands and feet can commonly develop. Due to the increased pressure within the hand, altered sensation, pain and hand/grip weakness can occur which makes this one of the more common pregnancy problems.

Carpal tunnel specifically refers to the wrist area, while De Quervain’s tenosynovitis refers to the base of the thumb. We may notice that hand/thumb pain or numbness predominantly occurs at night. This is likely due to the position the wrist or arm is resting in while we sleep. Pressure can build in the small joint spaces if our wrists remain bent for a period of time.

A Physiotherapist will be able to assess the painful areas and provide exercises, stretches, manual therapy as well as advice on the use of splints and activities during the day.

Hip pain

Hip pain is another frequent problem during pregnancy. As previously mentioned, soft tissue can become more lax thanks to the hormone, relaxin. This can lead to more movement around the hip joint which can cause pain. Commonly, we can experience hip pain at night when lying on our side due to the gradual pressure applied to the hip bones.

To help alleviate hip pain, good symmetrical alignment of our lower limbs while led in bed or sat upright should be considered. Sleeping with additional padding under our hip bone, as well as, placing a pillow between our legs at night can help reduce the strain on the hip joints. Keeping active and maintaining strong muscles will help support our joints regardless of relaxin.

A Physiotherapist can help guide you on appropriate exercises, stretches, sleeping positions and posture.

Diastasis recti

Diastasis recti refers to the separation of the superficial abdominal muscles during pregnancy. Due to the pressure and growth of our bumps, the abdominal muscles will do their best to stretch to accommodate the growth. Diastasis recti commonly occurs during the third trimester of pregnancy simply due to growth. We may feel discomfort or pain in our abdomen where the muscles have separated into two halves. As well as discomfort, we may also notice doming (a peak or bulge running vertically and centrally along the abdomen when moving in a sit-up position).

A Physiotherapist may be able to help. After a thorough assessment, they will be able to give us advice on posture and movement, as well as exercises to help stabilise the core during pregnancy and strengthen after pregnancy.

Pelvic floor weakness & incontinence

Due to relaxed ligaments and muscles, as well as the added pressure and weight of our babies, the pelvic floor can become weak leading to leaking urine (incontinence) – this is surprisingly high on the list of common pregnancy problems so do not be worried if you experience this. This can occur when changing position when coughing, sneezing or laughing or during sudden jarring movements like jumping.

It is important to spend some time completing pelvic floor exercises to help keep the muscles strong and prevent incontinence. The muscles of the pelvic floor are a combination of fast-twitch and slow-twitch muscle fibres. This is important because it means the muscles need to be trained in two different ways. The first exercise is a quick squeeze of the pelvic floor – try to complete three sets of ten repetitions. The second exercise is a slow, long squeeze of the pelvic floor – aim to hold the squeeze 10 seconds before relaxing.

If we become concerned about having a weak pelvic floor or suffer from incontinence, we can seek advice from either our midwife or a Physiotherapist. A Physiotherapist will be able to ensure you are completing the correct exercises, help increase your awareness of the pelvic floor and how to engage these muscles, as well as give you advice on diet and lifestyle, which may contribute to a weak pelvic floor.